The abscopal effect of immune-radiation therapy in recurrent and metastatic cervical cancer: a narrative review

Frontiers in Immunology

Immunology

Estelle Dhamelincourt¹  Emmanuelle Renaud¹  Camille Moreau Bachelard²  Luc Ollivier³  Francois Lucia⁴ 

[1] Department of Medical Oncology, CHRU Morvan, University Hospital, Brest, France;Department of Medical Oncology, Institut De Cancérologie De L’Ouest, Saint-Herblain, France;Department of Radiation Oncology, Institut De Cancérologie De L’Ouest (ICO), Saint-Herblain, France;Radiation Oncology Department, University Hospital, Brest, France;LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France;

关键词: abscopal effect;    immunotherapy;    radiation therapy;    cervical cancer;    immune checkpoint inhibitors;    metastastic cancer;   

DOI  :  10.3389/fimmu.2023.1201675

 received in 2023-04-06, accepted in 2023-06-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

Despite human papillomavirus vaccination and screening, in about 5% of cases, cervical cancer (CC) is discovered at an initial metastatic stage. Moreover, nearly one-third of patients with locally advanced CC (LACC) will have a recurrence of their disease during follow-up. At the stage of recurrent or metastatic CC, there are very few treatment options. They are considered incurable with a very poor prognosis. For many years, the standard of care was the combination of platinum-based drug and paclitaxel with the possible addition of bevacizumab. The most recent years have seen the development of the use of immune checkpoint inhibitors (ICIs) (pembrolizumab, cemiplimab and others) in patients with CC. They have shown long term responses with improved overall survival of patients in 1st line (in addition to chemotherapy) or 2nd line (as monotherapy) treatment. Another emerging drug is tisotumab vedotin, an antibody-drug conjugate targeting tissue factor. Radiation therapy (RT) often has a limited palliative indication in metastatic cancers. However, it has been observed that RT can induce tumor shrinkage both in distant metastatic tumors beyond the radiation field and in primary irradiated tumors. This is a rarely observed phenomenon, called abscopal effect, which is thought to be related to the immune system and allows a tumor response throughout the body. It would be the activation of the immune system induced by the irradiation of cancer cells that would lead to a specific type of apoptosis, the immunogenic cell death. Today, there is a growing consensus that combining RT with ICIs may boost abscopal response or cure rates for various cancers. Here we will review the potential abscopal effect of immune-radiation therapy in metastatic cervical cancer.

【 授权许可】

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Copyright © 2023 Ollivier, Moreau Bachelard, Renaud, Dhamelincourt and Lucia